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Bone malrotation refers to the situation that results when a bone heals out of rotational alignment from another bone, or part of bone. It often occurs as the result of a surgical complication after a fracture where intramedullary nailing (IMN) occurs, [1] especially in the femur and tibial bones, but can also occur genetically at birth.
A long-term effect of this is painful ankle osteoarthritis due to the direct contact between the tibia and talus. [10] [11] If a Maisonneuve fracture is left untreated, instability of the tibiotalar joint and deltoid ligament can cause a valgus deformity of the ankle.
In terms of fracture type, isolated malleolar fractures are most common (two-thirds of fractures); bimalleolar fractures occur in roughly 25% of patients while trimalleolar fractures occur in 5-10%. [10] Open fractures are rare, compromising 2% of all ankle fractures. [21] In children, ankle fractures occur in about 1 per 1000 per year. [3]
However, if there is widespread laxity of other connective tissue, then this may be a sign of Ehlers–Danlos syndrome, Down syndrome, Klippel–Feil syndrome, juvenile idiopathic arthritis, Larsen syndrome, Marfan syndrome, osteogenesis imperfecta, and other medical conditions. [1] [2]
Post-traumatic osteoarthritis is the most common variation of post-traumatic arthritis. [3] Between 20 and 50% [4] of all osteoarthritis cases are preceded by post-traumatic arthritis. Patients having post-traumatic osteoarthritis are usually younger than osteoarthritis patients without any previous physical injuries. [5]
Since most dislocations involving the joint near the fingertip (DIP joint) are due to trauma, there is often an associated fracture or tissue injury. [8] Hip dislocations are at risk for osteonecrosis of the femoral head, femoral head fractures, the development of osteoarthritis, and sciatic nerve injury.
Risk factors include bone fractures, joint dislocations, alcoholism, and the use of high-dose steroids. [1] The condition may also occur without any clear reason. [1] The most commonly affected bone is the femur (thigh bone). [1] Other relatively common sites include the upper arm bone, knee, shoulder, and ankle. [1]
Pott's fracture, also known as Pott's syndrome I and Dupuytren fracture, is an archaic term loosely applied to a variety of bimalleolar ankle fractures. [1] The injury is caused by a combined abduction external rotation from an eversion force.